CMS has proposed a 3.6% increase to the 2026 Physician Fee Schedule conversion factor for non-APM participants, alongside a 3.83% boost for those in qualifying alternative payment models.
For the first time, the agency would implement separate conversion factors based on APM participation. The proposal also includes a one-time 2.5% statutory increase and adjustments related to work RVUs and geographic cost factors.
While CMS positions these changes as steps toward fairer reimbursement, many physicians argue they fall short of keeping pace with inflation and the rising costs of running a practice. Three physician leaders joined Becker’s to discuss how they feel about the proposal.
Question: How do you feel about CMS’ planned 3.6% boost to the physician fee schedule? What do you wish was different about the proposal?
Editor’s note:These responses were edited lightly for clarity and length.
Triwanna Fisher-Wikoff, MD. Family Medicine Physician at Texas Health Care (Fort Worth): While I appreciate the sentiment behind CMS’ proposed 3.6% increase in the physician fee schedule — especially as it relates to supporting primary care physicians — the reality is that this adjustment still falls short. When measured against inflation and the rising costs of running a practice, the increase does not represent a true raise. Had CMS and Congress addressed the flaws in the sustainable growth rate formula over 20 years ago — ensuring physician payments kept pace with hospital reimbursements and inflation — this increase would be far more meaningful today.
This is particularly concerning for independent physicians, many of whom are reaching an inflection point where practice costs are outpacing revenue. As a result, more are being forced to sell to hospital systems or private equity firms, accelerating consolidation and diminishing clinical autonomy. Compounding this issue are ongoing threats of reimbursement cuts and the political instability surrounding federal healthcare funding. Without more meaningful, inflation-adjusted investments — and greater certainty in payment models — it will remain difficult to recruit, retain and sustain physicians in Medicare and Medicaid programs.
Harry Haus, MD. Medical Director of Dr. Haus & Associates (Erie, Pa.): The 3.6 % increase does not keep up with inflation. Sadly, this has been a fact for over 20 years. This is one reason private practice physicians are dropping out of Medicare. Hospital-owned physicians can get around this with facility fees as well as having the primary care doctor refer everyone to have tests and see a hospital owned specialist. Private investment firms try to increase procedures in physician practices since this increases revenue.
Jonathan Kamerlink, MD. Anesthesiologist at Florida Spine Associates (Boca Raton): While it’s encouraging to be recognized and receive increased compensation from CMS for our services, this gesture still overlooks the long-term value physicians bring to the entire healthcare system. A persistent gap remains between delivering high-value care and receiving fair compensation. In reality, these two things should not be mutually exclusive. I urge my fellow physicians to continue advocating for both exceptional patient care and equitable reimbursement for our work.
